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Introduction <p>The objective of this study was to investigate the association between number of comorbidities (NOC) with adrenal incidentaloma (AI) and autonomic cortisol hypersecretion (ACS) in obese individuals.</p> Methods <p>This cohort study included 855 obese individuals (males/females: 175/680), who presented with obesity and were screened with 1 mg dexamethasone suppression test (DST). Hypertension (HT); type 2 diabetes mellitus (T2DM); hyperlipidaemia (HL); coronary artery disease (CAD); frequency of AI (in 255 patients with imaging) data were obtained from patient files. Patients were categorized according to DST cortisol levels as &lt;0.9 μg/dL (group 1 [G1]), 0.9–1.8 μg/dL (G2) and &gt;1.8 μg/dL (G3, defined as ACS).</p> Results <p>Frequency of ACS and AI according to NOC; NOC-0 (0.5%, 2.5%), NOC-1 (0.9%, 15.8%), NOC-2 (3.4%, 23.5%), NOC-3 (4.1%, 15.1%), NOC-4 (13.6%, 35.7%). Increased frequency of ACS and AI in NOC-2, NOC-3, NOC-4 vs. NOC-0 group (<i>P</i> &lt; <i>0.05</i> for all). The prevalence of T2DM, HT, HL CAD and AI was lower in the group with a G1 (18.5%, 19.5%, 31.7%, 3.6%, 3%) compared to those in the G2 (43.8%, 70.5%, 52.7%, 12.5%, 52.4%, <i>P</i> &lt; <i>0.001</i> for all) and G3 (42.9%, 78.6%, 78.6%, 21.4%, 61.5%, <i>P</i> &lt; <i>0.001</i> for all), frequency of comorbidities and AI in G2 vs. G3 are similar. DST result was found to be an independent factor the presence of any comorbidity.</p> Conclusion <p>In obese individuals, NOC-2 and higher levels are associated with an increased incidence of AI and ACS. DST is a simple and reliable test to demonstrate this association, and a cut-off of 0.9 μg/dL may be more sensitive.</p>

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Number of comorbidities predicts adrenal incidentaloma and autonomic cortisol secretion in obese individuals: A two-center cohort study

  • 期刊论文

  • 发表日期：

    2025年7月30日

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  • Elif Güneş,
  • Mutlu Güneş,
  • Muhammet İlker Kaya,
  • Murat Yüksel,
  • Sümeyye Memet,
  • Beyza Kibar,
  • Cem Kaya,
  • Fatih Hakan Tufanoğlu,
  • Behiye Oral

摘要

Introduction

The objective of this study was to investigate the association between number of comorbidities (NOC) with adrenal incidentaloma (AI) and autonomic cortisol hypersecretion (ACS) in obese individuals.

Methods

This cohort study included 855 obese individuals (males/females: 175/680), who presented with obesity and were screened with 1 mg dexamethasone suppression test (DST). Hypertension (HT); type 2 diabetes mellitus (T2DM); hyperlipidaemia (HL); coronary artery disease (CAD); frequency of AI (in 255 patients with imaging) data were obtained from patient files. Patients were categorized according to DST cortisol levels as <0.9 μg/dL (group 1 [G1]), 0.9–1.8 μg/dL (G2) and >1.8 μg/dL (G3, defined as ACS).

Results

Frequency of ACS and AI according to NOC; NOC-0 (0.5%, 2.5%), NOC-1 (0.9%, 15.8%), NOC-2 (3.4%, 23.5%), NOC-3 (4.1%, 15.1%), NOC-4 (13.6%, 35.7%). Increased frequency of ACS and AI in NOC-2, NOC-3, NOC-4 vs. NOC-0 group (P < 0.05 for all). The prevalence of T2DM, HT, HL CAD and AI was lower in the group with a G1 (18.5%, 19.5%, 31.7%, 3.6%, 3%) compared to those in the G2 (43.8%, 70.5%, 52.7%, 12.5%, 52.4%, P < 0.001 for all) and G3 (42.9%, 78.6%, 78.6%, 21.4%, 61.5%, P < 0.001 for all), frequency of comorbidities and AI in G2 vs. G3 are similar. DST result was found to be an independent factor the presence of any comorbidity.

Conclusion

In obese individuals, NOC-2 and higher levels are associated with an increased incidence of AI and ACS. DST is a simple and reliable test to demonstrate this association, and a cut-off of 0.9 μg/dL may be more sensitive.